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Nursing Service Providers Registered Nurse Medical-Surgical

Provider NPI: 1902456783

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 503-220-8262  Fax: --

Business Mailing Address:
10300 SE WAVERLY CT APT 205  MILWAUKIE, OR 97222-7459 US
Tel: 503-780-3895  Fax: --

NPI Information:
NPI: 1902456783
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y163WM0705XNursing Service Providers
Registered Nurse

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 163WM0705X





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